Lloyd Jennifer J, Wyatt Katrina M, Creanor Siobhan
Institute for Health Service Research, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK.
BMJ Open. 2012 May 14;2(3). doi: 10.1136/bmjopen-2011-000390. Print 2012.
To assess the behavioural and weight status outcomes in English children in a feasibility study of a novel primary school-based obesity prevention programme.
Exploratory cluster randomised controlled trial of the Healthy Lifestyles Programme.
Four city primary schools (two control and two intervention) in the South West of England.
202 children aged 9-10 years, of whom 193 and 188 were followed up at 18 and 24 months, respectively. No child was excluded from the study; however, to be eligible, schools were required to have at least one single Year 5 class.
Four-phase multicomponent programme using a range of school-based activities including lessons, assemblies, parents' evenings, interactive drama workshops and goal setting to engage and support schools, children and their families in healthy lifestyle behaviours. It runs over the spring and summer term of Year 5 and the autumn term of Year 6.
Weight status outcomes were body mass index, waist circumference and body fat standard deviation scores (SDS) at 18 and 24 months, and behavioural outcomes were physical activity, television (TV) viewing/screen time and food intake at 18 months.
At 18 months of follow-up, intervention children consumed less energy-dense snacks and more healthy snacks; had less 'negative food markers', more 'positive food markers', lower mean TV/screen time and spent more time doing moderate-vigorous physical activity each day than those in the control schools. Intervention children had lower anthropometric measures at 18 and 24 months than control children, with larger differences at 24 months than at 18 months for nearly all measures.
Results from this exploratory trial show consistent positive changes in favour of the intervention across all targeted behaviours, which, in turn, appear to affect weight status and body shape. A definitive trial is now justified.
在一项针对小学的新型肥胖预防计划的可行性研究中,评估英国儿童的行为和体重状况结果。
健康生活方式计划的探索性整群随机对照试验。
英格兰西南部的四所城市小学(两所对照学校和两所干预学校)。
202名9至10岁的儿童,其中193名和188名儿童分别在18个月和24个月时接受了随访。没有儿童被排除在研究之外;然而,为符合条件,学校必须至少有一个五年级的单班。
采用四阶段多组分计划,运用一系列以学校为基础的活动,包括课程、集会、家长之夜、互动戏剧工作坊和目标设定,以促使并支持学校、儿童及其家庭养成健康的生活方式行为。该计划在五年级的春季和夏季学期以及六年级的秋季学期实施。
体重状况结果为18个月和24个月时的体重指数、腰围和体脂标准差分数(SDS),行为结果为18个月时的身体活动、看电视/屏幕时间和食物摄入量。
在随访18个月时,与对照学校的儿童相比,干预组儿童食用的高能量密度零食更少,健康零食更多;“负面食物指标”更少,“正面食物指标”更多,平均电视/屏幕时间更短,每天进行中等强度至剧烈身体活动的时间更多。干预组儿童在18个月和24个月时的人体测量指标低于对照组儿童,几乎所有指标在24个月时的差异都比18个月时更大。
这项探索性试验的结果表明,在所有目标行为方面,干预措施都产生了一致的积极变化,进而似乎影响了体重状况和体型。现在有理由进行一项确定性试验。